Effects of adding different doses of clonidine to intrathecal bupivacaine for spinal anesthesia in cesarean section

摘要

Purpose: This study investigated the effects of three different doses of clonidine in combination with intrathecal hyperbaric bupivacaine on the quality of the blockade and maternal-fetal repercussions in parturients undergoing elective cesarean section. Materials an Methods: Following ethics committee approval, ASA I and II patients of age group 20-35 years, scheduled for cesarean section, were chosen for this study. Patients were randomly distributed into three equal groups of 35 patients in each using a computer-generated sequence of numbers. The patients received hyperbaric bupivacaine (two ml) with 15 mu g of clonidine (BC15 group) or 30 mu g of clonidine (BC30 group) or 60 mu g of clonidine (BC60 group). Hemodynamic parameters, onset, peak and duration of sensory and motor block, sedation scores, Apgar scores, side effects, and duration of postoperative analgesia were compared. Results: All groups were comparable with respect to demographic profile, onset, peak and duration of sensory and motor block, and overall hemodynamic stability. The authors observed dose-dependent variability in duration of analgesia and sedation. Duration of analgesia was significantly higher in BC60 group as compared to the other two groups (577.13 +/- 120.30 vs. 422.06 +/- 112.47 and 376.21 +/- 87.21 minutes, respectively). Sedation was also more in BC 60 group. Conclusion: Intrathecal addition of 15 and 30 mu g clonidine are better options when sedation is not desirable; on the contrary, addition of 60 mu g provides excellent quality of spinal analgesia when some amount of sedation is acceptable or required without any deleterious effects on the mother and baby.